Effects of foam rolling on performance and recovery: A systematic review of the literature to guide practitioners on the use of foam rolling

Effect of Foam Roll recovery method on performance in water polo players: a randomized controlled trial

OBJECTIVES

This intervention study aimed to evaluate how the use of Foam Roller (FR) as a recovery strategy affects water polo performance after a seven-week (28-session) program.

DESIGN

A randomized controlled trial.

METHODS

Thirty water polo players (14 male amateur players and 16 female sub-elite players) were assigned by means of sealed opaque envelopes to the control group (CG) or Foam Roller Group (FRG) and performed the same total number and intensity of training sessions. Test protocols were performed before (pretest), in-test (week 5), and after the intervention period (posttest). These included water polo-specific performance tests such as in-water boost, throwing speed, and 20 m sprint swimming tests. In addition, during the intervention, heart rate (HR), the scale of perceived exertion of the session (sRPE), and total quality recovery scale (TQR) data were recorded.

RESULTS

There were no differences in the baseline values in any of the variables analyzed between CG and FRG. A small decrease in in-water boost was observed in CG (-2%, ES = -0.35 [-0.95: 0.26], p = 0.016, very likely small) and in FRG (-2%, ES = -0.33 [-0.93: 0.27], p = 0.021, likely small). No significant changes were found in either the 20 m swim test or the throwing test in CG and FRG. No clear differences among groups and weeks were found in sRPE, TQR and HR.

CONCLUSION

The findings indicate that the use of FR as a recovery tool after training and matches is not useful in water polo players.

Discussing Conflicting Explanatory Approaches in Flexibility Training Under Consideration of Physiology: A Narrative Review

The mechanisms underlying range of motion enhancements via flexibility training discussed in the literature show high heterogeneity in research methodology and study findings. In addition, scientific conclusions are mostly based on functional observations while studies considering the underlying physiology are less common. However, understanding the underlying mechanisms that contribute to an improved range of motion through stretching is crucial for conducting comparable studies with sound designs, optimising training routines and accurately interpreting resulting outcomes. While there seems to be no evidence to attribute acute range of motion increases as well as changes in muscle and tendon stiffness and pain perception specifically to stretching or foam rolling, the role of general warm-up effects is discussed in this paper. Additionally, the role of mechanical tension applied to greater muscle lengths for range of motion improvement will be discussed. Thus, it is suggested that physical training stressors can be seen as external stimuli that control gene expression via the targeted stimulation of transcription factors, leading to structural adaptations due to enhanced protein synthesis. Hence, the possible role of serial sarcomerogenesis in altering pain perception, reducing muscle stiffness and passive torque, or changes in the optimal joint angle for force development is considered as well as alternative interventions with a potential impact on anabolic pathways. As there are limited possibilities to directly measure serial sarcomere number, longitudinal muscle hypertrophy remains without direct evidence. The available literature does not demonstrate the necessity of only using specific flexibility training routines such as stretching to enhance acute or chronic range of motion.

Effectiveness of Recovery Strategies After Training and Competition in Endurance Athletes: An Umbrella Review

BACKGROUND

Recovery strategies are used to enhance performance and reduce injury risk in athletes. In previous systematic reviews, individual recovery strategies were investigated to clarify their effectiveness for mixed groups of athletes. However, the current evidence is ambiguous, and a clear overview of (training) recovery for endurance athletes is still lacking.

METHODS

We conducted an umbrella review based on a literature search in PubMed, Cochrane Database of Systematic Reviews, and Web of Science. Reviews published in English and before December 2022 were included. Systematic reviews and meta-analyses were eligible if they investigated the effectiveness of one or more recovery strategies compared with a placebo or control group after a training session in endurance athletes.

RESULTS

Twenty-two reviews (nine systematic reviews, three meta-analyses, and ten systematic reviews with meta-analyses included) met the inclusion criteria. In total, sixty-three studies with 1100 endurance athletes were included in our umbrella review. Out of the sixty-three studies, eight provided information on training recovery time frame for data synthesis. Among them, cryotherapy and compression garments showed positive effects, while applying massage showed no effect. In general, none of the included recovery strategies showed consistent benefits for endurance athletes.

CONCLUSION

There is no particular recovery strategy that can be advised to enhance recovery between training sessions or competitions in endurance athletes. However, individual studies suggest that compression garments and cryotherapy are effective training recovery strategies. Further research should improve methodology and focus on the different time courses of the recovery process.

REGISTRATION

The review protocol was registered with the International Prospective Register of Systematic Reviews with the number CRD42021260509.

Self-Massage Acute Effects on Pressure Pain Threshold, Muscular Electrical Activity, and Muscle Force Production: A Systematic Review and Meta-Analysis

ABSTRACT

Furlan, MR, Machado, E, Petter, GdN, Barbosa, IM, Geremia, JM, and Glänzel, MH. Self-massage acute effects on pressure pain threshold, muscular electrical activity, and muscle force production: a systematic review and meta-analysis. J Strength Cond Res 38(3): 620-635, 2024-Self-massage (SM) is often used in physiotherapy and sports training programs. However, the SM acute effects on pressure pain threshold (PPT), muscle electrical activity (MEA), and muscle force production remain unclear. A meta-analytical review was performed to verify the SM acute effects on neuromuscular responses in healthy adults or athletes. The review (CRD42021254656) was performed in the PubMed, Web of Science, and Embase databases. A synthesis of the included studies was performed, and both the risk of bias and the evidence certainty level were assessed through the PEDro scale and Grading of Recommendations Assessment, Development, and Evaluation approach, respectively. Nineteen studies were included, 5 evaluated the PPT, 7 the thigh muscles' MEA, and 15 the lower-limb strength. The SM application induces moderate increases in quadriceps' PPT (5 studies; standardized mean difference [SMD]: 0.487; 95% CI 0.251-0.723; p < 0.001; I2 = 0%). We found no SM effects on the hamstrings and plantar flexors' MEA. Also, we observed small increases in knee extensors' concentric torque (2 studies; SMD: 0.288; 95% CI 0.088-0.489; p = 0.005; I2 = 0%), without effects in isometric muscle strength, eccentric torque, and rate of force development. Grading of recommendations assessment, development, and evaluation analysis showed high and low certainty levels for the SM effects on quadriceps' PPT and muscle strength, respectively. Self-massage pressure-volume application seems to be a determining factor in inducing changes in these parameters, and it may vary among the treated muscles, where a higher pressure-volume application is required for increasing knee flexors and plantar flexors' PPT and strength. Thus, new studies with better methodological quality should be performed to strengthen this evidence.

Effects of foam roller on pain intensity in individuals with chronic and acute musculoskeletal pain: a systematic review of randomized trials

OBJECTIVE

To analyze the effects of using foam roller on pain intensity in individuals with chronic and acute musculoskeletal pain.

METHODS

This systematic review was registered in the National Institute for Health Research's prospective online registry of systematic reviews (PROSPERO) under CRD42023456841. The databases Pubmed, Medline (via Ovid), Embase, BVS, and PEDro (Physiotherapy Evidence Database) were consulted to carry out this systematic review. Notably, the records of clinical trials characterized as eligible were manually searched. The search terms were: (foam rolling OR foam rolling vibration) AND (acute musculoskeletal pain) AND (chronic musculoskeletal pain). The search was performed until August 22, 2023. For the analysis of the methodological quality, the PEDro scale was used for each of the manuscripts included in the systematic review. Due to the heterogeneity in the studies included in this systematic review, performing a meta-analysis of the analyzed variables was impossible.

RESULTS

Only six manuscripts were eligible for data analysis. The type of FR used was non-vibrational, being applied by a therapist in only one of the manuscripts. With an application time ranging from at least 45 s to 15 min, the non-vibrational FR was applied within a day up to six weeks. Using the PEDro scale, scores were assigned that varied between 4 and 8 points, with an average of 6 ± 1.29 points. Only two randomized clinical trials found a significant benefit in pain intensity of adding FR associated with a therapeutic exercise protocol in individuals with patellofemoral pain syndrome and chronic neck pain.

CONCLUSION

The results of this systematic review do not elucidate or reinforce the clinical use of FR in pain intensity in individuals with chronic and acute musculoskeletal pain.

Fundamentals or Icing on Top of the Cake? A Narrative Review of Recovery Strategies and Devices for Athletes

The sport and athletic performance industry has seen a plethora of new recovery devices and technologies over recent years, and it has become somewhat difficult for athletes, coaches, and practitioners to navigate the efficacy of such devices or whether they are even required at all. With the increase in recovery devices and tools, it has also become commonplace for athletes to overlook more traditional, well-established recovery strategies. In this narrative review, we discuss recovery strategies in relation to the hierarchy of scientific evidence, classifying them based on the strength of the evidence, ranging from meta-analyses through to case studies and reports. We report that foam rolling, compression garments, cryotherapy, photobiomodulation, hydrotherapy, and active recovery have a high level of positive evidence for improved recovery outcomes, while sauna, recovery boots/sleeves, occlusion cuffs, and massage guns currently have a lower level of evidence and mixed results for their efficacy. Finally, we provide guidance for practitioners when deciding on recovery strategies to use with athletes during different phases of the season.

Acute effects of foam roller or stick massage on indirect markers from exercise-induced muscle damage in healthy individuals: A systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis examined the effects of foam roller or stick massage performed after exercise-induced muscle damage protocols on indirect markers of muscle damage compared to a non-intervention control group in healthy individuals.

METHODS

PubMed, Biblioteca Virtual em Saúde, Scopus, Google Scholar, and Cochrane Library database were searched in August 2, 2020, with last update on February 21, 2021. Were included clinical trials involving healthy adult individuals who received foam roller/stick massage versus a non-intervention group and evaluated indirect markers of muscle damage. Risk of bias was assessed by the Cochrane Risk of Bias tools. Standardized mean differences with 95% confidence intervals were used to measure the foam roller/stick massage effect on muscle soreness.

RESULTS

The five included studies investigated 151 participants (136 men). Overall, the studies presented a moderate/high risk of bias. A between-groups meta-analysis showed no significant difference between massage and non-intervention control groups on muscle soreness immediately after (0.26 [95%CI: 0.14; 0.65], p = 0.20), 24 h (-0.64 [95%CI: 1.34; 0.07], p = 0.08), 48 h (-0.35 [95%CI: 0.85; 0.15], p = 0.17), 72 h (-0.40 [95%CI: 0.92; 0.12], p = 0.13), and 96 h (0.05 [95%CI: 0.40; 0.50], p = 0.82) after an exercise-induced muscle damage protocol. Moreover, the qualitative synthesis showed that foam roller or stick massage had no significant effect on range of motion, muscle swelling, and maximal voluntary isometric contraction recovery.

CONCLUSION

In conclusion, the current literature appears to not support the advantage of foam roller or stick massage to improve recovery of muscle damage indirect markers (muscle soreness, range of motion, muscle swelling, and maximal voluntary isometric contraction) compared to a non-intervention control group in healthy individuals. Furthermore, due to the heterogeneity of the methodological designs among the included studies, making it difficult to compare the results. In addition, there are not enough high-quality and well-designed studies on foam roller or stick massage to draw any definite conclusions.

REVIEW PROTOCOL NUMBER

The study was pre-registered in the International Prospective Register of Systematic Review (PROSPERO) on August 2, 2020, with last update on February 21, 2021. Protocol number: CRD2017058559.

Are Acute Effects of Foam-Rolling Attributed to Dynamic Warm Up Effects? A Comparative Study

Over the last decade, acute increases in range of motion (ROM) in response to foam rolling (FR) have been frequently reported. Compared to stretching, FR-induced ROM increases were not typically accompanied by a performance (e.g., force, power, endurance) deficit. Consequently, the inclusion of FR in warm-up routines was frequently recommended, especially since literature pointed out non-local ROM increases after FR. However, to attribute ROM increases to FR it must be ensured that such adaptations do not occur as a result of simple warm-up effects, as significant increases in ROM can also be assumed as a result of active warm-up routines. To answer this research question, 20 participants were recruited using a cross-over design. They performed 4x45 seconds hamstrings rolling under two conditions; FR, and sham rolling (SR) using a roller board to imitate the foam rolling movement without the pressure of the foam rolling. They were also tested in a control condition. Effects on ROM were tested under passive, active dynamic as well as ballistic conditions. Moreover, to examine non-local effects the knee to wall test (KtW) was used. Results showed that both interventions provided significant, moderate to large magnitude increases in passive hamstrings ROM and KtW respectively, compared to the control condition (p = 0.007-0.041, d = 0.62-0.77 and p = 0.002-0.006, d = 0.79-0.88, respectively). However, the ROM increases were not significantly different between the FR and the SR condition (p = 0.801, d = 0.156 and p = 0.933, d = 0.09, respectively). No significant changes could be obtained under the active dynamic (p = 0.65) while there was a significant decrease in the ballistic testing condition with a time effect (p < 0.001). Thus, it can be assumed that potential acute increases in ROM cannot be exclusively attributed to FR. It is therefore speculated that warm up effects could be responsible independent of FR or imitating the rolling movement, which indicates there is no additive effect of FR or SR to the dynamic or ballistic range of motion.

Response to Mechanical Properties and Physiological Challenges of Fascia: Diagnosis and Rehabilitative Therapeutic Intervention for Myofascial System Disorders

Damage to the fascia can cause significant performance deficits in high-performance sports and recreational exercise and may contribute to the development of musculoskeletal disorders and persistent potential pain. The fascia is widely distributed from head to toe, encompassing muscles, bones, blood vessels, nerves, and internal organs and comprising various layers of different depths, indicating the complexity of its pathogenesis. It is a connective tissue composed of irregularly arranged collagen fibers, distinctly different from the regularly arranged collagen fibers found in tendons, ligaments, or periosteum, and mechanical changes in the fascia (stiffness or tension) can produce changes in its connective tissue that can cause pain. While these mechanical changes induce inflammation associated with mechanical loading, they are also affected by biochemical influences such as aging, sex hormones, and obesity. Therefore, this paper will review the current state of knowledge on the molecular level response to the mechanical properties of the fascia and its response to other physiological challenges, including mechanical changes, innervation, injury, and aging; imaging techniques available to study the fascial system; and therapeutic interventions targeting fascial tissue in sports medicine. This article aims to summarize contemporary views.

Foam Rolling Acute Effects on Myofascial Tissue Stiffness and Muscle Strength: A Systematic Review and Meta-Analysis

ABSTRACT

Glänzel, MH, Rodrigues, DR, Petter, GN, Pozzobon, D, Vaz, MA, and Geremia, JM. Foam rolling acute effects on myofascial tissue stiffness and muscle strength: a systematic review and meta-analysis. J Strength Cond Res 37(4): 951-968, 2023-Foam rolling (FR) is widely used in rehabilitation and physical training. However, the effects of FR on myofascial tissue stiffness and muscle strength remain unclear. This study aimed to perform a systematic review with meta-analysis of trials that tested the FR acute effects during warm-up on the myofascial tissue stiffness and muscle strength in healthy adults or athletes. This systematic review (CRD42021227048) was performed according to Cochrane's recommendations, with searches performed in PubMed, Web of Science, Embase, and PEDro databases. Syntheses of included studies' data were performed, and the PEDro scale was used to assess the methodological quality of the studies. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluations approach. Twenty included studies assessed trunk and thigh fascial tissue stiffness, and thigh and calf muscle stiffness, whereas muscle strength was assessed in the knee extensors and flexors, and plantar flexors muscles. Qualitative analysis showed decreases in fascial ( n = 2) and muscle ( n = 5) stiffness after FR. However, the meta-analysis showed no effects of FR on myofascial tissue stiffness. Both qualitative and quantitative analyses showed no effects of FR on isometric muscle strength, eccentric torque, and rate of force development. However, the knee extensor concentric torque increased after FR. Foam rolling increases the knee extensor concentric torque, but it does not acutely change the myofascial tissue stiffness and isometric muscle strength. However, evidence of these studies provides low certainty to state that FR does not change these parameters. Therefore, high methodological quality studies should be performed to better ascertain the effects of FR on the myofascial tissue stiffness and muscle strength.

Effects of Different Recovery Modalities on Delayed Onset Muscle Soreness, Recovery Perceptions, and Performance Following a Bout of High-Intensity Functional Training

The purpose of this study was to investigate the effects of the foam rolling technique and static stretching on perceptual and neuromuscular parameters following a bout of high-intensity functional training (HIFT), which consisted of 100 pull-ups, 100 push-ups, 100 sit-ups, and 100 air squats (Angie benchmark) in recreationally trained men (n = 39). Following baseline measurements (Feeling Scale, Visual Analogue Scale, Total Quality Recovery, Sit-and-Reach, Countermovement Jump, and Change-of-Direction t-test), the volunteers performed a single bout of HIFT. At the end of the session, participants were randomly assigned to one of three distinct groups: control (CONT), foam rolling (FR), or static stretching (SS). At the 24 h time-point, a second experimental session was conducted to obtain the post-test values. The level of significance was set at p < 0.05. Regarding power performance, none of the three groups reached pretest levels at 24 h point of the intervention. However, the CONT group still showed a greater magnitude of effect at the 24 h time-point (ES = 0.51, p ≥ 0.05). Flexibility presented the same recovery pattern as power performance (post × 24 h CONT = ES = 0.28, FR = ES = 0.21, SS = ES = 0.19). At 24 h, all groups presented an impaired performance in the COD t-test (CONT = ES = 0.24, FR = ES = 0.65, SS = ES = 0.56 p ≥ 0.05). The FR protocol resulted in superior recovery perceptions (pre × 24 h TQR = ES = 0.32 p ≥ 0.05). The results of the present study indicate that the use of FR and SS exercises may not be indicated when aiming to restore neuromuscular performance following a single bout of HIFT. The use of the FR technique during the cooldown phase of a HIFT session may be helpful in improving an individual's perception of recovery.

Effectiveness of an 18-week general strength and foam-rolling intervention on running-related injuries in recreational runners

RATIONALE

More research is needed to uncover the effectiveness of combined strength and foam-rolling interventions to prevent running-related injuries.

OBJECTIVES

To evaluate effectiveness of an 18-week general strength and foam-rolling intervention on the incidence of running-related injuries.

METHOD

This is an 18-week observational comparative study. A total of 433 recreational runners participated (n = 203 female). The intervention group (n = 228) performed general strength and foam-rolling exercises twice weekly for 18 weeks, the control group (n = 205) maintained their regular training habits. Running volume and running-related pain were reported weekly. Secondary analyses were performed on the subgroups of the intervention group based on compliance; low compliance (n = 100), intermediate compliance (n = 63), and high compliance (n = 65). Cumulative incidence proportions were calculated and time-to-event statistics were performed to compare survival times between groups. Univariate cox proportional hazards ratio was calculated to estimate the risk of running-related injuries at 18 weeks.

RESULTS

A total of 100 running-related injuries were sustained. The cumulative incidence proportion for the control and intervention groups was 27.1% (95% CI: 21.4-33.9) and 23.0% (95% CI: 17.8-29.4), respectively. No statistically significant difference was found between the overall intervention group and control group (log-rank p = 0.31). A significant difference existed between the high-compliance subgroup and the control group (log-rank p = 0.00). Highly compliant runners were 85% less likely (hazard rate ratio = 0.15; 95% CI: 0.05-0.46) to sustain an injury during the study compared with controls.

CONCLUSION

Recreational runners highly compliant with the intervention were 85% less likely and took on average 57 days longer to sustain a running-related injury when compared with controls, with a cumulative incidence proportion of 4.6% after 18 weeks.

Does Vibration Foam Roller Influence Performance and Recovery? A Systematic Review and Meta-analysis

Background

Foam rolling has been extensively investigated, showing benefits in performance and recovery. Recently, vibration has been added to foam rollers, with hypothesized advantages over conventional foam rollers. However, there is no systematic evidence in this regard.

Objective

To carry out a systematic review and meta-analysis about the effects of vibration foam roller (VFR) on performance and recovery.

Methods

A systematic search was conducted in PubMed/MEDLINE, Web of Science and SportDiscus according to the PRISMA guidelines. The outcomes included performance (jump, agility and strength) and recovery variables (blood flow, pain and fatigue) measured after an intervention with VFR. The methodological quality was assessed with the PEDro scale. A random-effects model was used to perform the meta-analysis.

Results

Initially, 556 studies were found and after the eligibility criteria 10 studies were included in the systematic review and 9 in the meta-analysis. There was no significant effects on jump performance (SMD = 0.14 [95% CI − 0.022 to 0.307]; p = 0.101; I² = 1.08%) and no significant beneficial effects were reported on isokinetic strength (SMD = 0.16 [95% CI − 0.041 to 0.367]; p = 0.117; I² = 9.7%). Recovery appears to be enhanced after VFR interventions, but agility does not seem to increase after VFR interventions.

Conclusion

This systematic review and meta-analysis suggest that VFR could have great potential for increasing jump performance, agility, strength and enhancing recovery. Further research is needed to confirm the effects of VFR on performance and recovery.

Trial Registration This investigation was registered in PROSPERO with the code CRD42021238104.

Comparison Between Foam Rolling With and Without Vibration on Passive and Active Plantar Flexor Muscle Properties

Although foam rolling interventions with and without vibration have been used to increase flexibility in the field of sports, their effects on passive and active properties remain unclear. Hence, this study aimed to investigate the effects of foam rolling interventions on range of motion (ROM), shear elastic modulus, plantar flexor muscle strength, and jump performance. This randomized, controlled, crossover study included 16 healthy male participants who visited the laboratory three times (control condition, foam rolling condition, and vibration foam rolling condition), each with an interval of >72 h. In both foam rolling and vibration foam rolling conditions, participants were instructed to perform 60-s bouts of intervention for three sets, with 30-s rest between each set. In the vibration foam rolling condition, the intensity of vibration was set at a frequency of 48 Hz. Dorsiflexion (DF) ROM, shear elastic modulus, plantar flexor muscle strength, and drop jump height were determined before and after the rolling intervention. Our results showed a similar increase in DF ROM (p < 0.01, d = 0.51; p < 0.01, d = 0.65, respectively) and passive torque at DF ROM (p = 0.02, d = 0.51 and p < 0.01, d = 0.65, respectively) after foam rolling and vibration foam rolling. Medial gastrocnemius shear elastic modulus decreased only after vibration foam rolling (p < 0.01, d = 0.44). No significant main effects of time were observed in maximal voluntary isometric contraction torque (F = 2.0, p = 0.15, η_p² = 0.119) and drop jump height (F = 1.5, p = 0.24, η_p² = 0.091) after both interventions. Maximal voluntary concentric contraction torque showed a significant main effect of time (F = 7.59, p = 0.02, η_p² = 0.336). However, only after foam rolling, the maximal voluntary concentric contraction torque significantly decreased (p = 0.01, d = 0.39). Our results suggest that vibration foam rolling effectively alters passive muscle properties without decreasing muscle strength and performance.

Acute effects of vibration foam rolling and local vibration during warm-up on athletic performance in tennis players

Athletes are currently fond of vibration foam rollers (VFRs) and commercial portable vibration percussion devices (PVPDs). It is still unknown whether using these devices during warm-up has an immediate impact on athletic performance. A randomized block design was used in this study. The acute effects of VFR and PVPD on tennis players’ athletic performance during warm-up were compared. For the countermovement jump (CMJ), reactive strength index (RSI), and hexagon test (HT), the difference in performance between all interventions was significant (p = 0.007–0.034, η²_p = 0.266–0.364). Only those who received VFR had significantly different CMJ and HT results when compared to the control group (CMJ height = 53.18 ±4.49 cm, p = 0.03, d = 1.26; HT time = 10.73 ±0.4 s, p = 0.03, d = 1.12). Participants’ RSI values were significantly different after VFR (RSI = 2.01 ±0.11 cm·mm^–1, p = 0.012, d = 1.76) and PVPD (RSI = 1.99 ±0.11 cm·mm^–1, p = 0.025, d = 1.52) compared to the control group. Therefore, when using VFR and PVPD as part of warm-up protocols for tennis players of varying skill levels, VFR could have an immediate positive effect on power, reactive strength, and change of direction performance, while PVPD could immediately improve reactive strength performance.

Why Percussive Massage Therapy Does Not Improve Recovery after a Water Rescue? A Preliminary Study with Lifeguards

The aim of this study was to analyze the effects of percussive massage therapy (PMT) on lifeguards’ recovery after a water rescue, in comparison with passive recovery. Methods: A quasi-experimental crossover design was conducted to compare passive recovery (PR) and a PMT protocol. A total of 14 volunteer lifeguards performed a simulated 100 m water rescue and perceived fatigue and blood lactate were measured as recovery variables after the rescue and after the 8-min recovery process. Results: There were no differences between PMT and PR in lactate clearance (p > 0.05), finding in both modalities a small but not significant decrease in blood lactate. In perceived fatigue, both methods decreased this variable significantly (p < 0.001), with no significant differences between them (p > 0.05). Conclusions: PMT does not enhance recovery after a water rescue, in comparison with staying passive. Despite PMT appearing to be adequate for recovery in other efforts, it is not recommended for lifeguards’ recovery after a water rescue.

Chronic Effects of Foam Rolling on Flexibility and Performance: A Systematic Review of Randomized Controlled Trials

The purpose of this study is to review the existing literature on chronic effects of foam rolling (FR) on flexibility and performance. Electronic databases were searched during January 2022 for topics related to FR. Included studies met the following criteria: (a) peer-reviewed articles written in English; (b) FR intervention of at least four weeks; (c) non-motorized FR device during intervention; (d) randomized controlled trial with existence of a control group; and (e) any lower body parameter related to flexibility, recovery, and performance. Nine studies met that criteria. Results revealed that chronic FR demonstrated conflicting results for improvement of flexibility. On the other hand, a majority of the articles in this review showed no beneficial effects of FR on performance. Lastly, the effect of FR on recovery is unclear. These findings suggest the need for further studies to establish the consensus about the long-term application of FR in flexibility, recovery, and performance.

Chronic and Residual Effects of a Two-Week Foam Rolling Intervention on Ankle Flexibility and Dynamic Balance

Background

Foam rolling has been shown to acutely improve joint range of motion (ROM). However, limited knowledge exists on the chronic and residual effects. The primary purpose of this study was to examine the chronic and residual effects of a 2-week roller–massager intervention on ankle dorsiflexion ROM and dynamic balance.

Methods

Forty-two participants (24.3 ± 2.5 years, 33 males, 9 females) were randomly assigned to either roller-massage (RM) or control group (= no intervention). Ankle ROM was assessed with the weight-bearing lunge test (WBLT) and dynamic balance with the Y-Balance test for both limbs. The RM group was instructed to roll their calf muscles for three sets of 60 s per leg on 6 days a week over 2 weeks. Acute effects were measured during baseline testing for dorsiflexion ROM and dynamic balance immediately after foam rolling. Chronic and residual effects were measured 1 day and 7 days after the intervention period. Multivariate ANOVA was performed for post-hoc comparisons to determine acute, chronic, and residual effects.

Results

Significant acute and chronic foam rolling effects (p <0.05) were found for ankle dorsiflexion ROM. The chronic increase in ROM slightly decreased 7 days post-intervention but remained significantly above baseline (p < 0.05). Regarding dynamic balance, there were no acute but chronic (p < 0.05) and residual (p < 0.05) effects.

Conclusion

Using a roller–massager for a 2-week period chronically increases ROM and dynamic balance. These increases are still significant 7 days post-intervention emphasizing the sustainability of foam rolling effects.

Effects of Foam Rolling Duration on Tissue Stiffness and Perfusion: A Randomized Cross-Over Trial

Despite its beneficial effects on flexibility and muscle soreness, there is still conflicting evidence regarding dose-response relationships and underlying mechanisms of foam rolling (FR). This study aimed to investigate the impact of different FR protocols on tissue perfusion and tissue stiffness. In a randomized crossover trial, two FR protocols (2x1 min, 2x3 min) were applied to the right anterior thigh of twenty healthy volunteers (11 females, 25 ± 4 years). Tissue perfusion (near infrared spectroscopy, NIRS) and stiffness (Tensiomyography, TMG and Myotonometry, MMT) were assessed before and after FR application. Variance analyses revealed a significant interaction of FR duration and tissue perfusion (F_[1,19] = 7.098, p = 0.015). Local blood flow increased significantly from pre to post test (F_[1,19] = 7.589, p = 0.013), being higher (Δ +9.7%) in the long-FR condition than in the short-FR condition (Δ +2.8%). Tissue stiffness (MMT) showed significant main effects for time (F_[1,19] = 12.074, p = 0.003) and condition (F_[1,19] = 7.165, p = 0.015) with decreases after short-FR (Δ -1.6%) and long-FR condition (Δ -1.9%). However, there was no time*dose-interaction (F_[1,19] = 0.018, p = 0.895). No differences were found for TMG (p > 0.05). FR-induced changes failed to exceed the minimal detectable change threshold (MDC). Our data suggest that increased blood flow and altered tissue stiffness may mediate the effects of FR although statistical MDC thresholds were not achieved. Longer FR durations seem to be more beneficial for perfusion which is of interest for exercise professionals designing warm-up and cool-down regimes. Further research is needed to understand probable effects on parasympathetic outcomes representing systemic physiological responses to locally applied FR stimulations.

Expert Consensus on the Contraindications and Cautions of Foam Rolling-An International Delphi Study

Background: Foam rolling is a type of self-massage using tools such as foam or roller sticks. However, to date, there is no consensus on contraindications and cautions of foam rolling. A methodological approach to narrow that research gap is to obtain reliable opinions of expert groups. The aim of the study was to develop experts’ consensus on contraindications and cautions of foam rolling by means of a Delphi process. Methods: An international three-round Delphi study was conducted. Academic experts, defined as having (co-) authored at least one PubMed-listed paper on foam rolling, were invited to participate. Rounds 1 and 2 involved generation and rating of a list of possible contraindications and cautions of foam rolling. In round 3, participants indicated their agreement on contraindications and cautions for a final set of conditions. Consensus was evaluated using a priori defined criteria. Consensus on contraindications and cautions was considered as reached if more than 70% of participating experts labeled the respective item as contraindication and contraindication or caution, respectively, in round 3. Results: In the final Delphi process round, responses were received from 37 participants. Panel participants were predominantly sports scientists (n = 21), physiotherapists (n = 6), and medical professionals (n = 5). Consensus on contraindications was reached for open wounds (73% agreement) and bone fractures (84%). Consensus on cautions was achieved for local tissue inflammation (97%), deep vein thrombosis (97%), osteomyelitis (94%), and myositis ossificans (92%). The highest impact/severity of an adverse event caused by contraindication/cautions was estimated for bone fractures, deep vein thrombosis, and osteomyelitis. Discussion: The mechanical forces applied through foam rolling can be considered as potential threats leading to adverse events in the context of the identified contraindications and cautions. Further evaluations by medical professionals as well as the collection of clinical data are needed to assess the risks of foam rolling and to generate guidance for different applications and professional backgrounds.

Comparison of Immediate Effects of Foam Rolling and Dynamic Stretching to Only Dynamic Stretching on Flexibility, Balance, and Agility in Male Soccer Players

CONTEXT

Dynamic stretching (DS) is typically suggested during warm-up protocols. Also, foam rolling (FR), which is applied with a foam cylinder, has increased popularity in recent years. However, the combined effects of DS and FR in improving flexibility, dynamic balance, and agility performance are unclear in current literature. Therefore, this study aim to evaluate and compare the acute effects of DS as well as DS followed by FR (DS + FR) on flexibility, dynamic balance, and agility in male soccer players.

DESIGN

This study was a crossover study with a within-subject design.

METHODS

Thirty volunteer male soccer players (mean age 18.80 [0.66] y) were included in the study. Each participant performed the 2 sessions (DS and DS + FR) on separate occasions in a randomized order, with an interval of 72 hours. All sessions were performed in the indoor gym at the sports club. Flexibility was assessed by sit-and-reach test, dynamic balance was assessed by Y balance test, and agility was assessed by t test.

RESULTS

Compared with the pretest results, significant improvement in flexibility was observed in both groups (change = 0.55, percentage change = 2.05, effect size [ES] = 0.15, P = .041; change = 0.64, percentage change = 2.36, ES = 0.20, P = .025; respectively). Balance scores did not significantly improve in either group (change = 0.40, percentage change = 0.45, ES = 0.09, P = .342; change = 0.93, percentage change = 1.02, ES = 0.23, P = .103; respectively). Agility performance significantly improved in both groups (change = -0.12, percentage change = -1.18, ES = 0.19, P = .021; change = -0.21, percentage change = -2.18, ES = 0.38, P = .005; respectively).

CONCLUSIONS

Both DS and DS + FR improved flexibility and agility and did not affect balance. DS + FR was not superior to DS at improving flexibility and agility as compared only with DS. Both methods are effective warm-up protocols to augment factors related to injury risk and performance. It seems that further studies that investigate the combined effects of FR and DS are needed.

Effect of vibration foam rolling on the range of motion in healthy adults: a systematic review and meta-analysis

Professionals use foam rollers to improve range of motion (ROM). Recently, a vibrating foam roller (VFR) that combines the vibration function with a foam roller (FR) has been used. The purpose of this systematic review and meta-analysis was to determine the effects of a VFR on the improvement of ROM in healthy individuals. A systematic literature search was carried out in five international databases: PubMed, Embase, PEDro, Cochrane Library, and Google Scholar. Eight clinical studies, composed of six randomized controlled trials and two randomized crossover trials that involved 230 healthy participants were selected for analysis. Methodological quality was identified using the PEDro scale. The mean scores, 4.75±0.71, of the eight included studies, were classified as fair. The results demonstrated that the VFR achieved better gains than the FR in improving ROM (standardized mean difference [SMD], 0.53; 95% confidence intervals [CIs], 0.29–0.77; I²=55%). The VFR was more effective in improving the ROM than the FR in the hip and knee joints (hip: SMD, 0.56; 95% CI, 0.28–0.85; I²=0%; knee: SMD, 0.86; 95% CI, 0.42–1.30; I²=79%). The VFR may be an additional option to improve the ROM in healthy adults and athletes.

Effects of Warm-up on Hamstring Stiffness, Stress-Relaxation, Flexibility and Knee Proprioception in Young Soccer Players

CONTEXT

Nerves or fascia may limit motion in young soccer players, thereby contributing to frequent hamstring injuries. Nerve gliding exercises and self-myofascial release techniques may enhance the range of motion.

OBJECTIVE

The aim of this study was to compare the acute effect of foam rolling (FR) and neurodynamic nerve gliding (NDNG) on hamstring flexibility, passive stiffness, viscoelasticity and proprioception during the warm-up of soccer players.

DESIGN

Crossover study design.

SETTING

Research laboratory.

PARTICIPANTS

Fifteen male soccer players on the same team (age 18.0 ± 1.4 years, body mass 76.9 ± 7.8 kg, height 183 ± 6 cm).

INTERVENTION

FR and NDNG included six sets of 45 s with 15 s rest between each set. Over a two-week period subjects performed NDNG and FR on two separate occasions.

MAIN OUTCOME MEASURE(S)

Hip flexion angle (SLR), knee extension range of motion (ROM), knee joint position sense (AKJPS), hamstring passive resistance torque (PRT), stiffness (STFmax and STF80%) and viscoelasticity (stress-relaxation test (SRT)).

RESULTS

A significant interaction between time and intervention was found for knee ROM (p = 0.017), PRT (p = 0.044), and STFmax (p = 0.042). NDNG induced an increase in ROM (p = 0.011), PRT (p = 0.008), and STFmax (p = 0.030). Both NDNG and FR induced an increase in SLR (p < 0.001). No interaction or main effects was found for SRT and AKJPS.

CONCLUSION

The inclusion of NDNG in the warm-up routine increased the ROM more in comparison with FR and may be of benefit to soccer players.

Total Training Volume and Muscle Soreness Parameters Performing Agonist or Antagonist Foam Rolling between Sets

Background: Foam rolling (FR) has become very popular in recent years; however, the practice of FR between sets of resistance training (RT) for the lower limbs needs further examination. Purpose: Therefore, the purpose of the present study was to examine the effect of FR for the agonists (quadriceps) and antagonists (hamstrings) between multiple sets of the leg extension on repetition maximum performance (RM), fatigue resistance index (FRI), and muscle soreness (MS). Study design: Quasi-experimental clinical trial. Methods: Twenty trained men participated in this study (30.35 ± 6.56 years, 1.77 ± 0.05 cm, 87.70 ± 7.6 kg) and attended seven sessions with 48 h between sessions, (one familiarization session; two 10-RM test and retest sessions; and four experimental sessions). The four experimental sessions were performed in random order and included: agonist foam rolling (AFR), antagonist foam rolling (ANTFR), agonist/antagonist foam rolling (A/ANTFR), and traditional control (TP, without foam rolling). All sessions consisted of three sets for maximal repetitions with a 10-RM load for the leg extension. In the AFR and ANTFR sessions, there was a 120 s rest interval between sets, during which FR was done for the agonists or antagonists, respectively. In the A/ANTFR protocol, there was a 120 s rest interval between sets, during which FR was done for the agonists and antagonists. In the traditional protocol (TP), there was a 120 s passive rest interval between sets. Results: Regarding the total training volume (TTV), significant differences were noted between sessions (F_3,57 = 11.014; p = 0.0001). The AFR, ANTFR, and A/ANTFR sessions had significantly higher TTV versus the TP (p < 0.05). Regarding the FRI, significant differences were noted between sessions (F_3,57 = 2917, p = 0.042). A significantly higher fatigue index was shown for the ANTFR and AFR sessions versus the TP (p < 0.05). Regarding the total number of repetitions, significant differences were noted between sessions (F_3,57 = 11.086, p = 0.0001). The total number of repetitions was significantly higher in the A/ANTFR, ANTFR, and AFR versus the TP session (p < 0.05). MS was significantly lower in the A/ANTFR, ANTFR, and AFR sessions versus the TP session (p < 0.05). Conclusion: In conclusion, foam rolling between sets for the agonist or antagonist separately or in succession, resulted in greater neuromuscular performance and higher fatigue indices, as well as reducing the perception of acute muscle soreness.

Effects of self-myofascial release interventions with or without sliding pressures on skin temperature, range of motion and perceived well-being: a randomized control pilot trial

Background

Self-myofascial release is an emerging technique in strength and conditioning. Yet, there is no consensus regarding optimal practice guidelines. Here, we investigated the acute effects of various foam rolling interventions targeting quadriceps muscles, with or without sliding pressures.

Methods

We conducted a blinded randomized control pilot trial in 42 healthy weightlifting athletes over 4 weeks. Participants were randomly allocated to one of the four intervention (120 s massage routine) groups: foam rolling, roller massager, foam rolling with axial sliding pressures, foam rolling with transverse sliding pressures. Knee range of motion, skin temperature and subjective scores of the perceived heat, range of motion, muscle pain and relaxation were the dependent variables. Measurements were carried on before, after and up to 15 min (follow-up) after the massage intervention.

Results

The range of motion increased immediately after the various foam rolling interventions (+ 10.72%, 95% CI 9.51 to 11.95, p < 0.001), but progressively returned back to the pre-intervention baseline along within the 15 min post-intervention. Foam rolling was the most effective intervention to increase skin temperature from thermographic measures (+ 14.06%, 95% CI 10.97 to 17.10, p < 0.001), while the increase in perceived heat was comparable in all experimental groups (107%, 95% CI 91.08 to 122.61, p < 0.001).

Conclusions

Subjective indexes of heat, range of motion, muscle pain and relaxation improved immediately after the intervention, but also gradually returned to the pre-intervention baseline. Overall, combining foam rolling with sliding pressures did not yield additional benefits from objective measures.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-021-00270-8.

The Acute Effect of Foam Rolling and Vibration Foam Rolling on Drop Jump Performance

The purpose of this study was to examine the acute effect of foam rolling and vibration foam rolling on drop jump performance. The optimal time interval between warm-up using foam rolling or vibration foam rolling and drop jump performance was identified. This study included 16 male NCAA Division I college volleyball athletes. Three interventions were performed in a randomized order: the foam rolling exercise (FRE), vibration foam rolling exercise (VFRE), and static rest (control). The drop jump was performed before interventions, as well as 2 and 5 min after interventions. The FRE exhibited higher values for drop jump height (DJH) (p = 0.001; η² = 0.382; statistical power = 0.964) and mean power generation at the hip joint (p = 0.006; η² = 0.277; statistical power = 0.857) at 2 min compared with before intervention but not at 5 min (p > 0.05). However, the VFRE showed no significant changes in DJH (p > 0.05), and found that hip_power was decreased at 5 min (p = 0.027; η² = 0.214; statistical power = 0.680). The FRE completed in 2 min before rapid single action competition (sprint, long jump, triple jump, etc.) could increase sports performance.

Effects of myofascial release or self-myofascial release and control position exercises on lower back pain in idiopathic scoliosis: A systematic review

BACKGROUND

Idiopathic scoliosis is associated, among others, to muscular imbalance, functional limitations, and the most prevalent, back pain. The treatments usually applied are exercise, bracing or surgery. The objective of corrective exercise is to reduce symptoms and improve functional capacity and quality of life. Myofascial release (MFR) or Self-Myofascial release (SMFR) are manual techniques, intended to restore optimal muscle and fascia length, decrease pain, and improve function.

PURPOSE

to analyze the effects of MFR and postural control programs in lower back pain and scoliosis curves.

METHODS

A systematic literature review was conducted in high quality databases to identify the existing evidence of the effects of MFR and postural control on reducing back pain and scoliosis curves.

RESULTS

Seventeen studies met inclusion criteria. 533 subjects and 94 MFR/SMFR applied interventions lasting one to 24 weeks/sessions were identified. Ten studies used MFR, six SMFR and one mixes techniques. Seven MFR and five SMFR studies shown positive result. One study using MFR and one using SMFR applied also postural control exercises. MFR was useful to reduce back pain in all studies included that aimed in that matter. In addition, 12 studies reported improvements in flexibility and/or stiffness reduction, and two studies observed improvements in postural control and balance.

CONCLUSIONS

The combination of MFR and postural control programs might be suitable for reducing scoliosis and back pain. However, due to the reduced number of studies and the relatively small sample sizes used, results may be carefully interpreted, and more studies are needed.

Evaluating the effects of embedded self-massage practice on strength performance: A randomized crossover pilot trial

Background

Self-administered massage interventions with a roller massager are commonly used as part of warm-ups and post-workout recovery routines. There is yet no clear consensus regarding the practical guidelines for efficient embedded interventions.

Objectives

The present randomized crossover pilot trial aimed at examining the effects of a rolling intervention with a roller massager embedded within the rests periods of a resistance training protocol. The rolling intervention targeted quadriceps muscles.

Setting

Participants (n = 14) performed two resistance training protocols expected to elicit momentary muscle failure. The protocol consisted in 10 sets of 10 rest-pause repetitions of back squats, with a poundage set up at 50% of the maximal one-repetition. Two min were allocated to recovery between sets. During the recovery periods, participants completed a rolling routine with a roller massager for 60 s (Roller-massager), or underwent passive recovery (Control). The total workload, concentric power, thigh circumference rate of perceived exertion (RPE) and delayed onset of muscle soreness (DOMS) from 24 h to 120 h after completion of the protocol were the dependent variables.

Results

Roller-massager was associated with a reduction in total workload (-11.6%), concentric power (-5.1%) and an increase in perceived exertion compared to Control (p < 0.05). Roller-massager was also associated with reduced thigh circumference after the resistance training protocol, indicating reduced muscle swelling, and reduced DOMS 24 h to 120 h post-workout (p < 0.001).

Conclusion

These findings support that embedded rolling with a roller massager hinders performance and increases effort perception. Embedded interventions may not be suitable during conditioning periods designed to maximize training intensity.

Efficacy of foam rolling with additional vibration stimulation on the mobility of the thoracolumbar fascia. An observational study

INTRODUCTION

Observations show that foam rolling improves joint movements. Likewise, it can be stated that a vibration stimulation of the tissue leads to improved joint mobility.

METHOD

This study investigates whether the combination of foam rolling and vibrations (31 Hz) can influence the sliding of the thoracolumbar fascia more effectively than normal foam rolling. 45 subjects participated in the study and were divided into a foam roll with additional vibration group (FRV), a foam roll group (FR) and a control group (CG). The intervention groups rolled out the gluteal muscles, the lateral trunk and the upper and lower back. Mobility measures were taken pre and post the respective intervention. Subsequent cross correlation software analysis quantified the sliding of the fascia and calculated its shear strain mobility (SSM).

RESULTS

The sliding of the thoracolumbar fascia improved significantly within the FRV by 2.83 mm (SD ± 1.08/p < .001), in the FR by 0.96 mm (SD ± 0.43/p < .001) and in the CG decreased the sliding by 0.1401 mm (SD ± 0.28/p = .076). The fascia/fascia SSM increased in the FRV by 22.61% (SD ± 15.64/p < .001), in the FR by 11.41% (SD ± 20.38/p = .056) and in the CG decreased the SSM by 0.9473% (SD ± 11.35/p < .751). The lumbar movement increased in both intervention groups, but showed no significant result.

CONCLUSION

The use of a foam roll with additional vibration and standard intervention have increased thoracolumbar fascia sliding and lumbar movements. The improved shear strain mobility can be attributed to the multi-activity of mechanoreceptors, such as Pacini- and Ruffini-Bodies.

Selective Effects of Manual Massage and Foam Rolling on Perceived Recovery and Performance: Current Knowledge and Future Directions Toward Robotic Massages

Manual massage and foam rolling are commonly used by athletes for warm-up and recovery, as well as by healthy individuals for well-being. Manual massage is an ancient practice requiring the intervention of an experienced physiotherapist, while foam rolling is a more recent self-administered technique. These two topics have been largely studied in isolation from each other. In the present review, we first provide a deep quantitative literature analysis to gather the beneficial effects of each technique through an integrative account, as well as their psychometric and neurophysiological evaluations. We then conceptually consider the motor control strategies induced by each type of massage. During manual massage, the person remains passive, lying on the massage table, and receives unanticipated manual pressure by the physiotherapist, hence resulting in a retroactive mode of action control with an ongoing central integration of proprioceptive feedback. In contrast, while performing foam rolling, the person directly exerts pressures through voluntary actions to manipulate the massaging tool, therefore through a predominant proactive mode of action control, where operations of forward and inverse modeling do not require sensory feedback. While these opposite modes of action do not seem to offer any compromise, we then discuss whether technological advances and collaborative robots might reconcile proactive and retroactive modes of action control during a massage, and offer new massage perspectives through a stochastic sensorimotor user experience. This transition faculty, from one mode of control to the other, might definitely represent an innovative conceptual approach in terms of human-machine interactions.

The Recovery Benefit on Skin Blood Flow Using Vibrating Foam Rollers for Postexercise Muscle Fatigue in Runners

PURPOSE

To determine the effect of vibrating rollers on skin blood flow after running for recovery from muscle fatigue.

METHOD

23 healthy runners, aged between 20 to 45 years, participated in a crossover trial. Muscle fatigue was induced by running, and recovery using a vibrating roller was determined before and after the intervention. Each subject was measured at three time points (prerun, postrun, and postroller) to compare skin blood flow perfusion and blood flow oscillation at the midpoint of the dominant gastrocnemius muscle. The results show that blood perfusion is greater when a vibrating roller is used than a foam roller, but there is no statistical difference. The analysis of blood flow oscillation shows that vibrating rollers induce 30% greater endothelial activation than a foam roller. Vibrating rollers significantly stimulate the characteristic frequency for myogenic activation (p < 0.05); however, the effect size is conservative.

The effect of foam rollers of varying densities on range of motion recovery

OBJECTIVE

This study aimed to compare the effect of different density foam rollers on range of motion recovery.

METHOD

Ten active men completed two, 3-day trials in random order. During the experimental trials, all participants performed 2 min of foam rolling (FR) using a medium-density (medium trial) or hard-density (hard trial) foam roller on the right posterior thigh after completing the 90-min Loughborough Intermittent Shuttle Test (LIST). The hip joint range of motion (ROM), muscle hardness, and muscle soreness were assessed before and after the LIST and at 0 min, 20 min, 60 min, 24 h, and 48 h after FR intervention. Serum creatine kinase (CK) concentrations were assessed before the LIST and at 60 min, 24 h, and 48 h after FR intervention. The contralateral leg in each trial was used as a control.

RESULTS

The ROM at 0 min, 20 min, 60 min, 24 h, and 48 h after FR intervention were higher in the right leg (the massage leg) than in the left leg (the contralateral leg) (p < 0.05). In the right leg, the ROM at 0 min after FR intervention was higher than after the LIST (p < 0.05). There were no significant differences between the medium and hard trials for ROM. Muscle hardness, muscle soreness, and serum CK concentration were not affected by FR.

CONCLUSION

FR has a positive effect on ROM recovery. Moreover, the two roller densities provided similar ROM recovery.

Effects of Vibration Rolling with and without Dynamic Muscle Contraction on Ankle Range of Motion, Proprioception, Muscle Strength and Agility in Young Adults: A Crossover Study

Vibration rolling (VR) has emerged as a self-myofascial release (SMR) tool to aid exercise performance when warming up. However, the benefits of VR on exercise performance when combined with dynamic muscle contraction are unclear. The purpose of this study was to investigate the immediate effects of the combination of VR with dynamic muscle contraction (DVR), VR, and static stretching (SS) during warm-up on range of motion (ROM), proprioception, muscle strength of the ankle, and agility in young adults. In this crossover design study, 20 recreationally active adults without musculoskeletal disorders completed three test sessions in a randomized order, with 48 h of rest between each session. Participants completed one warm-up intervention and its measurements on the same day; different warm-up interventions and measurements were performed on each of the three days. The measurements included ankle dorsiflexion and plantarflexion ROM, ankle joint proprioception, muscle strength, and agility. After DVR and VR intervention, ankle dorsiflexion ROM (both DVR and VR, p < 0.001), plantarflexion ROM (both DVR and VR, p < 0.001), plantar flexor muscle strength (DVR, p = 0.007; VR, p < 0.001), and agility (DVR, p = 0.016; VR, p = 0.007) significantly improved; after SS intervention, ankle dorsiflexion and plantar flexion ROM (dorsiflexion, p < 0.001; plantar flexion, p = 0.009) significantly improved, but muscle strength and agility were not enhanced. Compared with SS, DVR and VR significantly improved ankle plantar flexor muscle strength (p = 0.008 and p = 0.001, respectively). Furthermore, DVR significantly improved ankle dorsiflexion compared with VR (p < 0.001) and SS (p < 0.001). In conclusion, either DVR, VR, or SS increased ankle ROM, but only DVR and VR increased muscle strength and agility. In addition, DVR produced considerable increases in ankle dorsiflexion. These findings may have implications for warm-up prescription and implementation in both rehabilitative and athletic practice settings.